Efficacy and continued technical improvements in CT pulmonary angiography (CTPA) have produced a significant rise in its use for the diagnosis of acute pulmonary embolism (PE). The growth of CTPA has produced a corresponding reduction in the utilization of pulmonary scintigraphy to the extent that some publications have suggested that lung scanning has become a second-line test. Lung ventilation/perfusion (V/Q) scintigraphy along with modified prospective investigation of pulmonary embolism diagnosis (PIOPED) interpretation criteria has been utilized to diagnose acute PE. More recently, a simplified algorithm comprising pulmonary perfusion scan along with prospective investigative study of pulmonary embolism diagnosis (PISAPED) interpretation criteria has shown a reduction of intermediate probability as one of the lung scan readings generated by the modified PIOPED criteria and has improved the sensitivity and specificity of the lung scintigraphy along with the modified PIOPED criteria to detect acute PE. Continue reading “PIOPED II, PISAPED and CTPA Criteria for Diagnosis of Pulmonary Embolus”
In 2000, IPF was defined as a specific form of chronic, progressive, fibrosing interstitial pneumonia of unknown cause, occurring primarily in older adults and limited to the lungs. Usual interstitial pneumonia (UIP) is the histopathological pattern of IPF. IPF is characterized by progressive worsening of dyspnea and lung function and is associated with a poor prognosis. Continue reading “Diagnostic Criteria for Idiopathic Pulmonary Fibrosis (IPF)”
The Wells Clinical Prediction Rule is a diagnostic tool used during review of systems to identify possible pulmonary embolism (PE) and deep vein thrombosis (DVT). Continue reading “Wells Clinical Prediction Rule for Pulmonary Embolism and Deep Venous Thrombosis”
Idiopathic interstitial pneumonias (IIPs) are part of a broad, heterogeneous group of interstitial lung diseases that encompasses more than 200 acute or chronic diseases with varying degrees of inflammation or fibrosis. Continue reading “ATS/ERS Criteria for Diagnosis of Idiopathic Pulmonary Fibrosis (IPF)”
The European Respiratory Society (ERS) diagnostic criteria for COPD include the following symptoms: coughing, sputum production and/or dyspnoea, as well as a history of exposure to risk factors for COPD. The diagnosis is confirmed by a post-bronchodilator FEV1/FVC < 0.7 in spirometry, as sign of the airflow limitation that is not fully reversible.
Continue reading “GOLD Staging System for Chronic Obstructive Lung Disease (COPD) Severity”
Patients with lesions on the chest radiograph should be discussed in a multidisciplinary meeting with a respiratory physician and radiologist at a minimum. Continue reading “Indications for Lung Biopsy”
The clinical diagnosis of amiodarone-induced pulmonary toxicity (APT) requires two or more of the following criteria:
- new onset of pulmonary symptoms such as dyspnea, cough, or pleuritic chest pain;
- new chest radiographic abnormality such as an interstitial or alveolar infiltrate;
- a decrease in the DLCO of 20% from the pretreatment value, or if none is available, a value less than 80% of predicted;
- abnormal lung uptake with gallium-67 radioisotope; and
- characteristic histologic changes of lung tissue obtained by bronchoscopic or open lung biopsy.
Continue reading “Diagnostic Criteria for Amiodarone-Induced Pulmonary Toxicity (APT)”